Science and Health

Bidirectional Links Between Metabolic and Mental Health Conditions

Here’s evidence on the interrelations of cardiometabolic and mental health and how to mitigate known risks with healthy lifestyle choices.

Scientists and clinicians have long investigated close relationships between physical and mental health disorders. The growing literature provides valuable perspectives, convincing evidence, and practical tips. The critical point is that lowering the risks of metabolic conditions might also lower mental health conditions.

In this article, I focus on giving helpful perspectives and some evidence from the literature on bidirectional links between mental health and cardiometabolic disorders like heart disease, stroke, or diabetes.

In simple terms, bidirectional links imply that depression and physical health conditions like heart disease or diabetes can affect one another. Depression may increase the risk of heart disease and diabetes. And these two physical conditions might increase the likelihood of depression.

For example, a depressed person is likelier to get heart disease or stroke than a non-depressed person. Or a diabetic person has likelier to get depression than a non-diabetic person.

As these links are highly complex and multifaceted, with manifold underlying mechanisms, I outline the key factors I learned from a comprehensive literature review in the last three decades and summarize a sample research paper published in January 2023.

I recently posted an article explaining the close connections between the gut and the brain by describing the brain-gut axis and providing three steps to regulate it.

In this post, after summarizing critical points for bidirectional links between cardiometabolic and mental health, I introduce valuable research published in the Journal of American Health Association earlier this year.

As I wrote many articles and discussed the impact and implications of cardiometabolic disorders and numerous mental health conditions, I will skip them in this article. You may check some of the links at the end of this article.

Besides, it is evident that a combination of physical and mental health disorders adversely affects millions and costs trillions of dollars to the global economy.

5 Factors Linking Physical and Mental Health

Mental and cardiometabolic health are closely linked, with bidirectional associations observed between the two. In this section, I outline key factors under five headings and discuss the essential mechanisms without going into scientific or technical details.

1 — Prolonged/Oxidative Stress [the Main Culprit]

Even though I theoretically knew the impact of stress on health like many others, I did not truly understand its detrimental effects on my life until my forties.

When I learned that chronic stress was the silent killer and started taking corrective actions for effective stress management, I only saw remarkable results after my 50s.

Some call these achievements (feeling younger as I get older) miracles, plastic surgery, or drugs. This is because authentic stress management is hardly covered in the media or the literature, and the public does not understand its importance.

As the term is overused, not many people take chronic stress seriously until it is too late, like having a heart attack, being diagnosed with diabetes, or experiencing severe depression.

Chronic stress is the most vital and well-documented link between mental and physical health. However, it is the most undermined and neglected aspect of our lives due to the demands of modern life. It is also due to the paradoxical nature of stress, as we cannot survive without some stress.

Literature indicates that chronic stress is a significant risk factor for mental health disorders, such as depression and anxiety, and cardiometabolic diseases, like type 2 diabetes, heart disease, and stroke.

Investigation on chronic stress shows that the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress response, is dysregulated in depression and metabolic disorders, leading to increased oxidative stress inflammation.

Oxidative stress adversely impacts genes, mitochondria, and other cell membranes, impacting tissues, organs, and systems.

In a previous article, I provided practical steps to prevent dysregulation of the HPA axis. I believe the previous story can provide you with a valuable perspective on the impact of this critical axis and its takeaway points.

2 — Chronic Inflammation

Chronic inflammation is another significant factor linking mental health and cardiometabolic health. Inflammation can result from mental health disorders, such as depression and anxiety, and metabolic disorders, such as obesity and diabetes.

The known mechanism behind the formation of chronic inflammation is the concept of inflammatory cytokines. An inflammatory cytokine is a signaling molecule (protein) secreted from our immune cells to protect us.

This is essential for our survival to respond and counteract invasions. However, in excessive amounts and prolonged time, inflammatory molecules can break the balance of the body and become toxic to our genes, mitochondria, cells, tissues, organs, and systems.

3 — Dysfunction of the Autonomic Nervous System

The autonomic nervous system (ANS) regulates critical physiological functions for maintaining homeostasis in the body. For example, ANS regulates breathing, heart rate, blood pressure, digestion, and more.

Stress and inflammation significantly impact these physiological functions, which I covered in the previous sections. The ANS manages the body’s stress response. It is controlled by the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

Dysfunctions in the ANS, SNS, and PNS and their dysregulation by chronic stress and other factors can adversely impact both mental health and cardiometabolic disorders.

For example, when the ANS is dysregulated, it can cause excessive activation of the SNS, leading to increased levels of stress hormones like (cortisol, adrenalin, and norepinephrine) leading to anxiety and depression.

As ANS regulates blood sugar and pressure, its dysregulation can lead to chronic hypertension and insulin resistance, known causes of heart disease and type II diabetes.

The SNS and PNS are essential for maintaining healthy blood glucose, a critical physical and mental health factor.

For example, SNS can stimulate the release of glucose from the liver into the bloodstream, increasing blood sugar levels. In contrast, the PNS can have the opposite effect by promoting glucose uptake by cells, which can lower blood sugar levels.

Dysregulation of the ANS can also lead to chronic inflammation, creating a catch-22 situation between physical and mental conditions. For example, chronic inflammation can affect the health of both the heart and the brain.

In depression, there is a predominance of sympathetic activity, leading to increased heart rate and blood pressure. In metabolic disorders, sympathetic activity increases, leading to insulin resistance and dysregulation.

Here’s How to Make the Nervous System More Flexible and Functional.

4 — Poor Health Behaviors

These behaviors revolve around our lifestyle choices. The common poor health behaviors are a sedentary lifestyle, overeating, nutritional deficiencies, sleep deprivation, and addictions.

Besides chronic stress and inflammation, which I covered in previous sections, poor health behaviors cause hormonal and other biochemical imbalances which can affect cells, tissues, organs, and systems.

For example, a sedentary lifestyle, overeating, and sleep deprivation can cause insulin resistance associated with type II diabetes, cardiovascular disorders, neurodegenerative diseases, and mental health conditions.

There are many more hormones and neurotransmitters affected by this poor health behavior. Addiction can also affect the balance of the body. For example, substance abuse can impact both the body and mind.

5 — Genetics and Epigenetics

I left this to the end as we have less control over this aspect. Literature indicates that genetics might also influence the bidirectional links between mental health and cardiometabolic health.

Shared genetic risk factors have been identified for depression, dementia, obesity, type 2 diabetes, and cardiovascular disease. Some genes like COMT, SLC6A4, FTO, and BDNF can affect mood, appetite, and energy levels, critical physical and mental health factors.

For example, I have been investigating the effects of the BDNF gene for a long time. If this gene causes a low level of BDNF (Brain-Derived Neurotrophic Factor), it can lead to depression and obesity. Higher levels of BDNF can put the brain in growth mode and lower the risks of metabolic syndrome.

However, our knowledge of related genes is limited, and it is impossible to create definitive conclusions at this stage. We cannot do much about our genes and DNA considering the limitations of our current capabilities.

However, we might influence our genes by changing our poor health behaviors, gaining healthy lifestyle habits, improving stress responses, lowering inflammation, and enhancing overall behavior for health and well-being.

At a high level, these crucial factors can allow the good genes to turn on and the bad ones to turn off, giving us a better genetic profile. This is called epigenetics which is a relatively new and growing discipline. Our current knowledge is limited, but it looks promising for our future.

Summary of New Research Showing Association of Depression and Poor Mental Health With Cardiovascular Disease

In this section, I’d like to briefly summarize a paper published in the Journal of American Health Association earlier this year. It references 59 previously published medical reports and is available publicly.

The paper's title is “Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States.”

A dozen authors of this well-written paper examined data from a survey of 593,616 young adults in the United States. They investigated how depression and poor mental health days are related to cardiovascular disease and suboptimal cardiovascular health.

The researchers found that people with depression had higher odds of having cardiovascular disorders than those without depression.

They identified a graded association between the number of depression and cardiovascular disease. Similarly, people with depression had higher odds of having suboptimal cardiovascular health than those without depression.

These associations did not differ significantly by sex or urban/rural status. This suggests that poor mental health is a risk factor for both suboptimal cardiovascular health, and interventions to improve mental health may also improve cardiovascular health.

They concluded, "Depression and poor mental health are associated with premature cardiovascular disease and suboptimal cardiovascular health among young adults. Although this association is likely bidirectional, prioritizing mental health may help reduce CVD risk and improve CVH in young adults.”

They informed that “A multidisciplinary approach and collaborative and integrated care between health care professionals, such as mental health physicians, psychologists, psychiatrists, nutritionists and addiction specialists, primary care physicians, and cardiologists, may be needed to better improve mental health and reduce cardiovascular disease risk.”

Conclusions

Based on my literature reviews, the bidirectional links between cardiometabolic and mental health emphasize the importance of holistic health, wellness, and lifestyle choices supporting physical and mental well-being and an integrative medicine approach.

Bidirectional links between cardiometabolic and mental health are complex and multifaceted, with multiple mechanisms. Our knowledge is limited, but there is a growing literature, as highlighted in this article.

Until scientists and practitioners can better understand these links and associations and find better solutions, the viable options are following healthy lifestyle habits and obtaining timely social help and professional support.

Takeaways

1 — The best approach to improve metabolic and mental health is to avoid poor health habits and gain healthy lifestyle routines like customized nutrition, balanced calories, restorative sleep, regular exercise, rest, recovery, and fun.

2 — Try to shift from sugar to fat-burning metabolism to optimize hormones, lower oxidative stress, reduce chronic inflammation, and initiate autophagy and mitophagy, clearing garbage from cells.

3 — Protect your mental health by practicing self-care and self-love, managing stress with a balanced lifestyle, improving social connections, and getting timely professional help.

4 — Be mindful of mental health signs and get regular checkups with our physicians, who can monitor our cardiometabolic conditions.

5 — An integrative mental and physical health approach can produce better results. In addition, leveraging both traditional and alternative therapies following holistic health principles can deliver preventative measures.

Insulin resistance and hyperinsulinemia adversely affect the brain and cognitive function. Here is what we can do about it. Here are two easy ways of boosting brain chemistry.

Thank you for reading my perspectives. I wish you a healthy and happy life.

As a new reader, please check my holistic health and well-being stories reflecting my reviews, observations, and decades of experiments optimizing my hormones and neurotransmitters.

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